by Janet Wolfson PT, CLWT, CS, CLT-LANA
Manual lymphatic drainage (MLD) was developed by Emil and Estrid Vodder in the 1930s. They dedicated their lives to the study of lymphatic anatomy and physiology. Since then, others have modified the original techniques, including Foeldi, Leduc, Casley-Smith, and Bjork. They all involve manual contact with the client, deep diaphragmatic breathing, stimulation of the lymph nodes, and movement of fluid from proximal and then distal areas. The manual contacts are slow, gentle, and rhythmic. Practitioners are typically occupational or physical therapists, physical and occupational therapy assistants, nurses, massage therapists, and physicians. Many practitioners, after a required 135-hour training program, complete the Lymphedema Association of North America (LANA) certification exam.